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Inspection carried out on 29 March 2018

During a routine inspection

Wood Close is a residential care home that provides accommodation and personal support for up to six adults with learning disabilities. There were five people using the service at the time of our inspection.

When we last visited the home on 29 October 2015 the service was meeting the regulations we looked at and was rated Good overall and in all five key questions. At this inspection we found the service continued to be Good.

Systems were in place to protect people from abuse and neglect and staff received training in safeguarding to understand their responsibilities.

Risks relating to people’s care were assessed and managed safely. The premises were well maintained and met people’s support needs. Suitable infection control processes were in place.

Staff were recruited through processes to check they were suitable to care for people. There were enough staff to care for people safely.

People were supported to maintain their health and in relation to eating and drinking by staff. People’s medicines were managed safely. People were supported by staff on admission to hospital.

People were supported by staff who received training and support to understand their roles and responsibilities.

People received care in line with the Mental Capacity Act 2005 and the provider applied for and followed authorisations to deprive people of their liberty as part of keeping them safe appropriately. People’s needs and choices were assessed and people and relatives were involved in the process.

Staff understood people and cared for them with kindness. Staff understood the best ways to communicate with people. People were treated with dignity and respect. People were supported to maintain their independent living skills.

People’s care plans were person-centred and contained sufficient information for staff to follow in caring for people. People were supported to do activities they were interested in and to maintain relationships with people who were important to them.

A suitable complaints process was in place and the provider responded appropriately to concerns or complaints.

Although there was no registered manager in post a manager had been in post for five months and was in the process of registering with the CQC. The manager had a good understanding of their role and responsibilities, as did staff. Leadership was visible in the service.

The provider had quality assurance systems with a range of audits in place. The provider encouraged open communication with people, relatives and staff. The provider carried out formal observations to find out the experiences of people who were non-verbal and to check staff provided care in the best ways.

Inspection carried out on 29 October 2015

During a routine inspection

This inspection was carried out on the 29 October 2015 and was unannounced. Wood Close provides accommodation for up to six adults with learning disabilities. It is a detached house in a residential setting, close to the town of Redhill, Surrey. At the time of inspection there were four people who lived at the service.

On the day of our visit there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The new manager had applied to the CQC to become the registered manager.

Risks to people had been assessed and managed appropriately to keep people safe. Staff understood risks to people and what actions to take to reduce risks.

There were enough staff to meet people’s needs. On the day of the inspection staff were supporting people when they needed. Appropriate recruitment checks were carried out on staff to ensure they were suitable to support the people that lived at the service

Accidents and incidents with people were recorded with information included detail of what happened, who was involved, who had been informed and what actions were taken. Staff had knowledge of safeguarding adult’s procedures and what to do if they suspected any type of abuse.

People’s medicines were administered and stored safely. In the event of an emergency, such as the building being flooded or a fire, there was a service contingency plan which detailed what staff needed to do to protect people and make them safe.

People were supported by staff that were knowledgeable and supported in their role. Staff were kept up to date with the required service mandatory training which was centred on the needs of the people living at the service. Staff received appropriate supervisions with their manager.

People at risk of dehydration or malnutrition had effective systems in place to support them. One relative told us “(The family member) gets enough to eat and drink.”

People’s human rights were being protected because the requirements of the MCA and DoLS were being followed. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes.

People were supported to remain healthy. One relative told us “They always take (the family member) to the GP if they need to go.” People had access to a range of health care professionals, such as the Epilepsy team, dietician and GP.

Staff were seen to be caring towards people and people’s dignity and privacy was maintained. One relative said “Staff are excellent, they are very good with (my family member) and with me.” Relatives told us that they were involved with the plan of care for their family member. Staff understood about people’s life history and family.

People were supported by staff that were given appropriate information to enable them to respond to people effectively. Care plans were detailed and provided staff with what they needed to support people.

Relatives told us that their family members led an active life outside of the service. One relative said “(The family member) enjoys working; they go out regularly when they want to. There was a list of regular activities that people participated in which included clubs, shopping, music therapy, walks and trips to the town.

Relatives told us that they knew how to make a complaint if they needed. One told us “I would speak to the staff at the home, if I wasn’t satisfied I would go to the provider, I’ve never made a formal complaint, I had an issue but that was dealt with.” There was a complaints procedure in place for people and relatives to access if they needed to.

Staff were supported by the management team and were involved in the running of the service.

Systems were in place to monitor the quality of the service that people received including audits and surveys to relatives. The Care Quality Commission were informed of information about the service when they needed to.

Inspection carried out on 2 January 2014

During a routine inspection

Because of the complex needs of the people we met on the inspection, they were unable to tell us directly about their experiences of living at Wood Close. To address this, we used a variety of other methods to assess the care and support provided. For example, we spoke with relatives, one of whom said, "The care is wonderful and the staff are very friendly". We also noted that the home provided a wide variety of social and educational opportunities for people living at the home in both individual and group settings.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

Inspection carried out on 25 March 2013

During a routine inspection

People using the service had complex needs, including various abilities of communication. This meant that it was difficult for the five people to tell us about their experiences of using the service. To gain a view we spent time observing the care and support people received from staff.

We were introduced to people and allowed them to take the lead on how much they wanted to interact with us, which was very minimal. We also talked with a relative who spoke positively about the service which they said was, “Very, very good,” and described the staff as, “Very caring.”

We saw good interaction and could see that people liked and trusted staff. For example, we saw people were comfortable approaching staff, and that staff treated people in a respectful, kind and professional manner.

Staff supported people with their communication and behavioural needs. We saw that the staff were attentive, and their knowledge of people’s individual behaviours was used in the identification of potential ‘triggers’ (such as the presence of a stranger in their home) which could cause a person distress.

Reports under our old system of regulation (including those from before CQC was created)